Prostate Cancer: Experience at King Abdulaziz University Hospital, Jeddah

Abstract

This paper presents the experience of King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia, with prostatic cancer patients seen over a period of more than ten years (1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997). Fifty-five patients with confirmed diagnosis of prostate cancer were identified at KAUH during this period. Forty-seven presented primarily to KAUH and eight were referred from other centers for management and/or follow-up. Data analyzed included age at presentation, ethnic origin, mode of presentation, result of digital rectal examination (DRE), results of serum tumor markers, prostatic acid phosphatase, or prostatic specific antigen (PSA), results of transrectal ultrasonographic scan of the prostate (TRUS), methods and results of prostate biopsy, pathological grade of the cancer tissues, the clinical staging, and finally the type of treatment used. The average age at presentation was 68.8 years. Forty-one patients were white, six were black and the ethnic origin was not determined in eight patients. The main clinical presentation was by symptoms of prostatism in 36 patients (65%). DRE revealed benign prostatic hyperplasia (BPH) in 31 patients (56%) and suspicion of cancer in 24 (44%). Of the patients with adenocarcinoma of the prostate, 27 had PSA measurements, elevated above 20 ng/mL in 17 (63%). The tissues were obtained from the prostate by needle biopsy in 30 patients (transperineal approach in 17 and TRUS-guided in 13 patients), prostatectomy in 17 patients (open in one, and transurethral prostatic resection in 16 patients), and unspecified method in eight patients. TRUS performed on 18 patients showed hypoechoic nodules indicative of cancer in 11 patients and BPH or normal in seven patients. Clinical staging revealed 15 (27%) in stage A, 5 (9%) in stage B, 5 (9%) in stage C and 30 (55%) in stage D. During this period no retropubic radical prostatectomy operation aimed at curing localized prostate cancer was performed at KAUH, while bilateral orchiectomy for control of metastatic disease was done for 12 patients, and 18 patients received endocrine therapy. Ann Saudi Med 1997; 17(6):590-594.

Variants of BORIS minisatellites and relation to prognosis of prostate cancer

“…Under the Jewett-Whitmore system, prostate tumors are classified into stages A, B, C and D. Stage A and B, as early stages, are not palpable or becoming palpable, but still remain intracapsular. Stage C and D show cancer invasion, spreading to other organs/tissues and may present bone metastases, bladder outlet obstruction or hydronephrosis (Mosli, 1997). In our study, 10.0% of patients were classified as group A, 40.5% as group B, 21.7% as group C, and 27.9% as group D. Prostate cancer patients with rare alleles were distributed as follows: A (0%), B (26.7%), C (53.3%), and D (20.0%).…”

Prostate Cancer: An update on the recent advances in the diagnosis and management with special reference to Saudi Arabia

“…Therefore, MOH hospitals would not be a valid source of data in regard to PSAbased screening for prostate cancer among BPH and other patients [34] . Table 3 summarizes the clinical presentation of CaP patients in Saudi Arabia [17,30,[35][36][37] . The rates of incidental cancer discovered after prostatectomy for a presumed clinically benign disease (stages T1 & T1b) in Saudi Arabia are detailed in Table 1.…”

“…Al Otaiby [35] Al Kudair [36] Mosli [17] Abmelha [37] Al Otaiby [30] Center City/area guide needle biopsy. When cancer nodule is present, it appears as a discrete hypoechoeic area.…”

“…Adversely and significantly affecting the quality of life, this operation commonly results in urinary incontinence, erectile impotence and bladder neck stenosis [2][3][4][5][6] . Most of the operated Saudi patients had this operation done in the USA [17] . Twenty patients only were subjected to this operation during 1989 to 1998 at the Dhahran Health Center (DHC) [31] .…”

“…We reported our own experience with this cancer. Although it was a series of small number of patients, but the report was successful in stimulating the interest of others in a previously locally neglected subject and in drawing the attention to the fact that 55% of the patients presented in an advanced stage of the disease [17] . Whether the incidence will rise with aging of the male population and with more widely spread use of PSA and performing more surgeries for presumed Benign Prostatic Hypertrophy (BPH) remains to be seen [13] .…”